Looking at the films and examination reports brought back by the hiccuping patient, Liu Banxia sighed inwardly. He had overestimated; it wasn’t stage II.
He had just been telling the interns to practice their communication with patients and families, yet now he found himself at a loss for words.
"Doctor, just tell . I can take it," the patient said, speaking first.
"The pancreatic tumor is quite large. Based on the current test results, it may have progressed to stage III. At this stage, even with surgery, the prognosis isn’t very good," Liu Banxia said, choosing his words carefully.
"Hic... Doctor, how long can I live if I don’t have surgery?" the patient asked.
"Maybe just three or four months. After surgery and chemotherapy, the two-year survival rate is around 40%, and the five-year survival rate will be lower," Liu Banxia replied.
"Your family isn’t here, and I can guess you haven’t figured out how to tell them yet, so I’ll tell you the situation directly. As a doctor, I naturally hope you’ll undergo surgery; after all, there’s still a chance that way."
"However, I must also tell you plainly that the prognosis is very poor. We can see that the tumor has already invaded the blood vessels, which is a strong indicator of stage III."
"If you’re asking for my recomndation, I’d suggest trying conservative treatnt with radiotherapy and chemotherapy first to see how effective it is. Although pancreatic cancer isn’t highly sensitive to radiotherapy and chemotherapy, there’s still so chance."
"If you choose to have surgery, we can perform it. However, even after surgery, you’ll still need to undergo radiotherapy and chemotherapy. I think you should discuss this with your family. Don’t try to shoulder everything yourself."
The patient pounded his chest forcefully. "So, Doctor, you’re saying if I have the surgery, I’ll waste a lot of money and continue to suffer, all just to live a few more months?"
Liu Banxia hesitated for a mont before nodding slightly. The patient had put it bluntly, but that was essentially it.
Besides, for stage III pancreatic cancer, surgery is generally not recomnded. The prognosis is simply too poor. While it can temporarily delay death, the extra ti gained is often filled with suffering.
"Thank you, Doctor."
The patient stood up, said this sincerely, and then walked out of Liu Banxia’s office.
DING!
Quest: The Hiccuping Patient - Complete.
Reward: 200 Experience Points, 100 Diagnostics Skill Proficiency Points.
The experience reward was ager because the patient’s condition hadn’t been particularly complex.
But Liu Banxia wasn’t bothered by this. He rubbed his face. This was the helplessness of a doctor. Known dical science offered no way to help the patient. The helplessness was absolute.
"Is the situation not good?" Wei Yuan asked when Liu Banxia ca out of his office.
"Stage III, and it has invaded the blood vessels. From the looks of it, he’s probably decided to forgo treatnt and enjoy the ti he has left," Liu Banxia said.
"Sigh... To be honest, I think that’s a pretty good choice," Wei Yuan sighed.
He was also a general surgeon; he naturally knew what stage III pancreatic cancer signified. It’s precisely because one understands that one might choose to give up.
"How’s your patient with cirrhosis?" Wei Yuan asked.
Liu Banxia shook his head with a bitter smile. "Still haven’t found a donor. If we can’t find one by tomorrow, it’ll be up to the family to decide. Su Hongbo isn’t optimistic; he’s already issued two critical condition notices for the patient."
"Although Su Hongbo didn’t say it explicitly, I suspect that even if we happen to find a donor tomorrow, it might not change much. The patient’s heart failure is quite severe."
"Well, try not to dwell on it too much for now. Not every patient waiting for an organ transplant gets a perfect outco. We have many such cases in our hospital. Many kidney disease patients wait so long for dialysis that they run out of viable access points for the needles," Wei Yuan advised.
Liu Banxia nodded. He knew Wei Yuan was right, but when it involved his own patient, it always felt different.
"Dr. Liu, we just received a call! Two yachts collided. Four patients are being sent to our hospital!" the dispatch nurse shouted at that mont.
"Four patients? Brother Wei, can you take charge of this round?" Liu Banxia asked.
"Alright. The four of us will supervise and assist. Let the interns handle them," Wei Yuan said.
"Everyone, listen up! Xu Yino, Huang Bo, Miao Rui, and Li Hao, you’ll be responsible for triaging the next four injured patients. Yacht collision, get moving!" Liu Banxia announced.
Hearing his words, Xu Yino and the others sprang into action, donning disposable surgical gowns and rushing to the entrance of the ergency center to wait.
"Patient was subrged! Showing signs of hypothermic shock!" a paradic announced as the first ambulance pulled up after a short wait.
"Follow ! To the examination bed for treatnt!" Xu Yino directed.
Wang Chao glanced over and imdiately followed her.
"Temperature 36 degrees Celsius, blood pressure 80/110, heart rate 110! Head laceration, open fracture of the left tibia. Bleeding controlled with a tourniquet, IV fluids started!" a paradic reported as the second ambulance arrived.
"Follow ! Trauma Room 1!" Huang Bo directed.
Liu Banxia went with this group, as Miao Rui was Wei Yuan’s intern and Li Hao was Qi Wentai’s. Moreover, this patient had an open fracture.
"Connect to monitors! Rapid blood panel! Dr. Liu, please examine the patient’s left leg fracture. I’ll conduct the initial trauma assessnt," Huang Bo ordered.
Liu Banxia moved around the examination bed, lifted the blanket covering the patient, and palpated the leg. "Open fracture of the distal left tibia and fibula. Suspected vascular damage. The left foot is cold, no circulation."
"Physical exam: Head laceration bleeding is controlled, ready for suturing. Heart and lung sounds are normal. Abdon is soft. Everyone clear! X-ray for the left tibia! Get Doctor Wu from Orthopedics! Book an OR!" Huang Bo instructed.
Liu Banxia nodded. His approach was sound. Even if it were him, and despite having privileges for so orthopedic procedures, he would still call an orthopedic specialist to consult and outline the treatnt plan.
Moreover, this patient might have damaged a blood vessel, which was why the paradic had applied a tourniquet; he needed to go to surgery imdiately. If blood flow couldn’t be restored quickly, he could lose his left foot.
With this patient’s condition assessed, Liu Banxia went back outside.
"Is your patient stable too?" Liu Banxia asked, seeing Wang Chao walk over.
"Just so near-drowning and mild hypothermia. He’ll be fine after so supportive care," Wang Chao replied.
This patient’s condition wasn’t serious. At worst, he might develop a lung infection later, but that was nothing compared to the last one.
"I have to go straight to the OR! His abdon was sliced open, seawater got in, and there’s intestinal damage!" At that mont, Wei Yuan and Miao Rui rushed out of Trauma Room 2 with a patient, tossing out the words as they dashed towards the elevator.
This patient’s condition was complex. He must have lost a significant amount of blood, and the dirty seawater had caused considerable contamination of the abdominal cavity. Prolonged exposure of the intestines also put the patient’s life at risk.
Liu Banxia and Wang Chao went to Trauma Room 3, where Li Hao and Qi Wentai were managing a patient.
"Vital signs are stable, but the right hurus was severed by a propeller blade. The severed arm hasn’t been found yet," Qi Wentai said as they entered.
Liu Banxia frowned. Although the patient just sent to the OR was in critical condition, if they could save him, he’d likely recover without major long-term issues. This patient, however, likely had the worst prognosis of the four. If a severed limb is detached for too long, reattachnt becos impossible, even if it’s found. Moreover, most people are right-handed, which would significantly impact this patient’s future life.
"Wang Chao, go take a break. You have another surgery waiting," Liu Banxia said.
Wang Chao nodded and left. Liu Banxia stayed to watch Li Hao debride the stump of the patient’s arm.
This was a delicate task. While it didn’t require the extre ticulousness of so of his own past procedures, it still demanded careful removal of devitalized and contaminated tissue.
"Found it! Found it! Where’s the patient?"
Less than ten minutes later, shouts ca from outside.
Liu Banxia walked out to see a paradic holding a severed arm wrapped in cling film.
"He’s in here! Qi Wentai, take the severed arm directly to an OR for debrident! Once the debrident on the patient’s stump is finished, we’ll take him in. I’ll call an orthopedic surgeon," Liu Banxia said hurriedly.
"Okay!"
Qi Wentai responded, took the severed arm, and ran towards the elevator.
Liu Banxia quickly took out his phone and dialed Xu Peichen’s number.
"Dr. Liu, Director Xu is in surgery right now," a nurse’s voice answered.
"Could you please ask him if there’s another orthopedic surgeon available who can perform a limb replantation? It’s a right hurus," Liu Banxia said urgently.
"Dr. Liu, Director Xu said that Vice Director Wang of Orthopedics probably doesn’t have any surgeries scheduled this afternoon," the nurse said after a mont.
"Please thank Director Xu for ." After saying that, Liu Banxia hung up, found the number for Wang Bo, the Vice Director of Orthopedics, and dialed it directly.
"Wang Bo speaking," Wang Bo answered after three rings.
"Teacher Wang, hello. This is Liu Banxia from the Ergency Center. We’ve just admitted a patient with a right hural amputation. We need your expertise for a limb replantation."
"Okay, I’ll head over to your side now. Get an OR coordinated," Wang Bo replied without hesitation.
"Thank you, Teacher Wang," Liu Banxia said quickly.
Even though saving lives was as urgent as fighting a fire, Wang Bo’s unhesitating agreent was a significant favor.
Liu Banxia finally felt a bit relieved. Limb replantation surgery was no easy feat. Blood vessels, nerves... any error in reconnecting them would an a failed surgery. If their luck held, all four patients today could be successfully treated. For the current ergency center, that would be a real shot in the arm.
"Teacher Liu, the patient’s wound site has been debrided. But the contamination is too severe, and there’s a lot of devitalized tissue with no blood supply," Li Hao reported, stepping out at that mont.
Hearing his words was like having a bucket of cold water poured over Liu Banxia. For the patient, this was truly the worst possible news.
User Comments
0 comments from readers